Healthcare Provider Details

I. General information

NPI: 1396483210
Provider Name (Legal Business Name): PRM TEXAS GYNECOLOGY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2022
Last Update Date: 05/20/2022
Certification Date: 05/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9301 N CENTRAL EXPY STE 410
DALLAS TX
75231-0805
US

IV. Provider business mailing address

2090 PALM BEACH LAKES BLVD STE 700
WEST PALM BEACH FL
33409-6508
US

V. Phone/Fax

Practice location:
  • Phone: 972-729-6044
  • Fax: 469-729-6044
Mailing address:
  • Phone: 561-805-3873
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: LINDA SOLIMINE
Title or Position: VICE PRESIDENT, OPERATIONS
Credential:
Phone: 561-805-3873